Healthcare Provider Details

I. General information

NPI: 1013697044
Provider Name (Legal Business Name): SCRIPT HEALTH CLINICAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/24/2023
Last Update Date: 08/01/2023
Certification Date: 08/01/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

222 MERCHANDISE MART PLZ STE 1230
CHICAGO IL
60654-4342
US

IV. Provider business mailing address

222 MERCHANDISE MART PLZ STE 1230
CHICAGO IL
60654-4342
US

V. Phone/Fax

Practice location:
  • Phone: 312-999-0154
  • Fax:
Mailing address:
  • Phone: 312-999-0154
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code1835P2201X
TaxonomyAmbulatory Care Pharmacist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: JAMES LOTT
Title or Position: CEO
Credential:
Phone: 425-227-9307